浅部真菌病病原酵母菌构成调查及药敏研究

目的了解本地区浅部真菌病病原酵母菌感染菌种的构成及其耐药性特点,为临床提供病原学诊断和合理使用抗真菌药物的依据。方法采用改良沙氏培养基对1354份临床标本进行酵母菌培养和菌株分离,用科玛嘉念珠菌显色培养基和YBC鉴定卡对所分离的酵母菌进行鉴定,用ROSCO纸片扩散法检测分离菌株对6种常见抗真菌药物的耐药性。结果共分离出10种219株酵母菌,甲真菌病检出率最高(43.80%),其次是股癣(16.70%)、体癣(13.00%)、足癣(11.11%),手癣最低(9.40%)。其中白念珠菌为63.47%;近平滑念珠菌为17.81%;热带念珠菌为6.85%;季也蒙念珠菌为5.94%;无名念珠菌为2.28%,其他酵母菌为3.65%。219株酵母菌对特比萘芬(TBE)、伊曲康唑(ITC)、氟康唑(FLC)、制霉菌素(NYS)、咪康唑(MIC)和酮康唑(KTC)的敏感性分别为53.42%、87.21%、97.26%、100%、80.35%和100%,耐药性分别为20.55%、11.11%、2.28%、0.0、12.72%和0.0。结论本地区浅部真菌病酵母菌感染菌谱以白念珠菌为主,其次是近平滑念珠菌和热带念珠菌,体外药敏显示对制霉菌素、酮康唑和氟康唑有很好的敏感性,对特比萘芬、伊曲康唑和咪康唑产生了较高的耐药性。

Distribution and antifungal susceptibility of yeast-like fungi isolated from superficial mycoses

Objective To investigate know distribution and susceptibility of yeast-like fungi from superficial mycoses in Shantou area. Methods Yeast-like fungi isolated from 1354 superficial mycoses samples were indentified by CHROMagar candida medium and YBC card. The susceptibility testing was performed by ROSCO method. Results Two hundred and ninteen strains of 10 species of yeast-like fungi were isolated. The isolating rate of tinea unguium, tinea cruris, tinea corporis, tinea pedis and tinea manuum were 43.80%, 16.70%, 13.00%, 11. 11% and 9.40%, respectively. The rate of Candida albicans , Candida parapsilosis , Candida tropicalis , Monilia guiUiermondii , Candida famata and other Candida were 63.47 % , 17.81% ,6.85 % ,5.94% ,2.28% and 3.65% ,respectively. Among 219 strains of yeast-like fungi, the susceptibility and resistance rate to terbinafine, itraconazole, fluconazol, nystatin, miconazole and Ketoconazole were 53.42% ,20.55% ; 87.21% ,11.11% ; 97.26% ,2.28% ; 100% ,0.0% ; 80.35% ,12.72% ; 100% ,and 0.0%, respectively. Conclusion Candida albicans and Candida parapsilosis are the major yeastlike fungi with superficial mycoses in Shantou area. High sensitivety to nystatin, ketoconazole, fluconazol and itraconazole were found.